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Once when I was in hospital, a doctor (or nurse, or someone, I don’t recall exactly, I was ill) asked whether I “identify” with my bipolar diagnosis. Later that week someone else said “I can see your diagnosis is something you really identify with.”

I have really mixed feelings about what it means to “identify” with a diagnosis. I know that psychiatry is not an exact science, so there is guess-work and a subjective sense of what fits where, and how. So yes, in a sense, I do identify with the diagnosis of bipolar. I recognise in myself the highs and lows, the behaviours, thoughts and attitudes that come with them. Textbook. And the acknowledgement of this, of my recognition, brings some positive results with it: more helpful prescriptions, a framework for treatment, and (the usefulness of this is underestimated) a logic within which others can read me.

On another hand, even if psychiatry is aiming at a pinata in the dark and hoping for a lucky strike, I’m not sure a diagnosis should be something you “identify” or “don’t identify” with. Certainly, I can say when something doesn’t feel right to me. If someone diagnoses me with an illness whose symptoms I cannot recognise in myself, I can definitely make the case for this not being my diagnosis. This will hopefully lead to the results I mentioned above, re: treatment.

But some people don’t “identify” with their diagnosis- nor do they necessarily identify with any. The pressure to hammer square symptoms into the round holes of diagnoses can lead to counterproductive outcomes. For example: over-diagnosis of some conditions because some of the symptoms fit for many people and there’s nowhere else to put them; diagnosing people with an illness of which they have only one or two symptoms; abandoning hope for some people, assuming that their lack of place within the rigid structures available means that they have no illness at all (and that because of this, the symptoms of the now-non-illness need not be taken seriously anymore). Not everyone “identifies” with a diagnosis, but that doesn’t mean nothing is wrong.

In addition, while I understand that psychiatry is inexact and sometimes a blunt tool for a fine operation, I think if you are going to use something as medical-sounding as “diagnoses”, you can’t afford to put that much emphasis on “identification.” Nobody “identifies” as having a physical health condition. And no, physical and mental health conditions are not the same- despite what people say, they are often not even similar- but if you are using the same language, giving the same weight to the same words, you need to have something behind those words. Something that doesn’t just depend on whether someone “feels” like you might be right.

I know I have written before about how I “have” rather than “am” bipolar. It might not seem like an important distinction, but the point I was making at that time was that recognising the signs and symptoms of an illness within yourself, doesn’t mean that these define you. They may be important and have a big effect on shaping who you are, but this doesn’t mean that they are all you are. The diagnosis, the illness, isn’t necessarily intrinsic. But something not being an identity in and of itself, doesn’t mean that it isn’t tangible in real terms. For example, I don’t think of myself as “identifying” as a lesbian. I just am one. It’s not something I picked and chose to call mine, like being a goth or an emo or a banana or whatever. It’s something I consider intrinsic and ingrained, which would exist regardless of my own understanding of it (whether cultural or personal). In the same way, I don’t think bipolar is something I “identify” with. It’s something I think explains a lot of my symptoms, and for me it is a useful framework to work within. However, this exactly the reason that I don’t think of it as something I identify with. I have it, or I don’t. The diagnosis is useful to me, or it isn’t. The language of identification doesn’t belong in medicine of any kind. Not from the same people who, when you “identify” as mentally healthy, take this to be a symptom of your illness. No. You can’t identify your way in or out of a problem.

Like this:

Recently, someone I know to be an otherwise compassionate and intelligent person made a comment that seemed to be minimising the seriousness of Bipolar II. The comment itself is not really important, and it’s possible that I read the tone wrong (although I did not mishear the content). The way it was made reminded me of a friend I once had who dismissed bipolar as a “casual illness.” It wasn’t that the comment was made in an unkind way; it struck me as uninformed. This surprised me, because it was not said by someone I would expect to be uninformed, and not said by someone I have known to be dismissive; yet the comment was both.

Essentially, the person suggested that Bipolar II is not a “serious” illness and doesn’t cause “severe vulnerability”, as compared with other illnesses which are much harder to “recover” from (my thoughts on “recovery” are available here and I believe, and have seen, that people can and do experience recovery from and within all sorts of illnesses, even those deemed most severe). I hear this kind of thing a lot: “just” depression, “just” [insert any number of illnesses]. But in my experience, “just” depression, “just” Bipolar II, are things that can actually kill. As in, quite literally, cause death.

What I wanted to say/ should have said/ didn’t say to this person, is that I don’t have the luxury of taking bipolar lightly. On more than one occasion, I have almost lost my life because of it. On more than one occasion I have lost friends, jobs, opportunities, because of it. I will probably be taking medication for the rest of my life. I will always be sensitive to the changes in my mood, the way a sailor learns to be sensitive to the wind. I cannot afford to take any period of wellness for granted, and I can’t afford to be flippant about it. If you can, then count yourself lucky, and educate yourself on the topic before you say something. (The person, by the way, did acknowledge that there were things that s/he didn’t know about bipolar/ depression. Which is absolutely fine, most people are not walking medical encyclopedias. But if you don’t know something, it is probably better to do a superficial google browse before dismissing as casual the illness of a person you know has that illness, in front of that person).

I know where I’m fortunate, by the way. I know that (especially at the moment, not being consumed by any particular mood) I am lucky, and I have zero interest in playing a game of comparisons. I am also aware that some people are impacted much more severely by bipolar (I or II) than I am (currently). My point isn’t that my particular mental state, at this particular time, is better or worse than that of anyone else. My point is that it isn’t the name of the illness that should shape your perception of it. “Personality disorder” or “bipolar” or “schizophrenia” or “PTSD” are all different conditions. The severity of each varies from person to person- not necessarily from diagnosis to diagnosis. No two people, with the same diagnosis, will be impacted in the same way by it. People can and do have periods- even long periods- of stability within the trajectory of their illnesses of any kind. Some illnesses have higher “recovery rates” than others, some have lower “relapse rates”, the likelihood of recurrence varies. But you should never put the word “just” before anything. It disrespects the experiences of the person with the problem. It makes you look like you don’t really care.

I haven’t posted to this blog for ages. In fact, I haven’t written at all for months. Truthfully—because I aim always to tell the truth here—I have been stuck in the realm of negativity. It sounds odd (or melodramatic) but even the weight of a biro between my fingers has felt like too much of a responsibility to bear. And so, at least in terms of the written word, I have stayed silent. Or is it better to say, invisible? For a long time, as a kid, if you’d asked me to choose a superpower I would have asked for invisibility. But in the real world, outside fantasy, for me, that isn’t possible. Whether or not I feel seen, my actions have consequences and impacts that ensure I am perceived. It is up to me, like it is up to everyone else, to try through those actions to shape positive impacts, worthy consequences. One thing I do that I know has some small impact is this blog so, in the spirit of growing visible again, I want (for the first time in months) to write. To write honestly.

In the realm of negativity, I felt I encountered a split path. “Two roads diverged in a yellow wood/ And sorry I could not travel both/ And be one traveller, long I stood” (Robert Frost). I have stood here a long time. Except, unlike Frost, I saw many splits in the path and for all I squinted through the yellow wood, I couldn’t see past the trees. I still can’t. I recognise (and thank) the fact that I have so many choices in my life. But choice can also be overwhelming. I feel overwhelmed.

I’ve always been a “big picture” person. Take the mundane example of housework: I often feel like things are done when other people can (apparently) clearly see that they are not. I notice the general gleam. Others notice the smudge on the skirting, the dust in the corners. It has its benefits and its drawbacks, this big picture view. The thing with being a “big picture” person, is that you learn to see the picture even when there is none. It’s a bit like doing a jigsaw puzzle. Even though large chunks may be missing and the image may be fragmented, you know that this is temporary and so you hold in your mind a vision of the image that should be there and disregard the pieces that aren’t. This is uplifting in some ways. It lends hope because you know that no matter what, all these pieces (even the missing ones) are part of something greater. On the other hand, though, it is impossible to go through life simply not noticing that there are vital things missing from the picture. When you step closer, you notice the flaws and they can floor you. That’s how I’ve been feeling. Floored by flaws, unsettled. A person without a plan.

I’ve been here before, in this wood with the diverging paths. I’ve been here so often you’d think I’d have built a treehouse by now. But I haven’t, so is it a wonder I feel exposed? Is it a wonder I have the sense of having failed?

That’s it, though. The old clichés, the crappy Facebook memes, are true: if I haven’t given up, I haven’t failed. I almost gave up. In almost doing so, I could almost have lost everything and yet… here I am. Standing on shaky legs, sure, but standing nonetheless. It’s bleak sometimes, it’s dark sometimes, it’s hard always, but I’m here.

I wasn’t going to write. I was going to stay invisible. And then, last night, I was giving another person subtle advice and as always when giving another person advice, it felt easy. There’s time to figure things out, I said. It’s not over, I said. Nothing is ever perfect, I said, but that doesn’t mean things can’t be good. It doesn’t even mean they can’t be great. I looked at someone else’s tangle of paths and I saw a multitude of futures in them. It would be hypocritical, then, to look at my own and see none. Really, I still can’t see my own clearly. I am exactly as lost as I was before. But there are ways out (compasses, maps, guidance). Ways to higher ground from which, I hope, I will be able to see the bigger picture once again.

Like this:

The sub-category Bipolar II was created in 1994, by a man named Allen Frances. Imagine that- my diagnosis is younger than me.

There are many criticisms of the DSM and one of them is that, in its various incarnations, it has created a “false epidemic” of mental illness. By adding new disorders and subcategories it has, it is argued, medicalised many of the normal emotions of everyday life.

Sometimes I feel as though bipolar II is belittled, both in terms of the minimalisation of its severity and in terms of some people thinking it isn’t an illness at all, not in its own right. In turn, when I am depressed, that makes me feel guilty. So, my diagnosis isn’t even a thing. So, why take medication? Isn’t it normal to soar and fall? Isn’t that what life is? What if, after all, I am drawing resources away from the people who really need it?

But I am brought out of this by the very depression that leaves me guilty in the first place. Because it isn’t normal. It isn’t normal to feel suicidal and it isn’t normal to have your thoughts race at fifty kilometres an hour, or to sleep four hours in two days for two weeks running. I am not a little off-kilter, not “just” suffering from the stresses of the modern world. When I am ill, I am ill.

I have to admit scepticism at the ever-expanding catalogue of mental illnesses and at the number of people diagnosed (a study showed that children born towards the end of a school year are many times more likely to be diagnosed with ADHD, because nobody had taken into account their relative immaturity). But as a sub-category myself, who am I to judge? If a person can put their finger on a diagnosis- even one whose creation seems arbitrary- and find it fits them perfectly, then they should probably try the recommended treatment for that disorder. I guess.

One thing I do know is that my medication works for me. Call it a placebo effect if you like. Call it whatever. But as they say, if it ain’t broke don’t fix it. Psychiatry may well be broken but I’m not, and in part that is due to my treatments.

Perhaps I should stop reading up on placebo and the failure of psychiatry. Perhaps it is making me unduly paranoid about diagnoses and treatments. I’m a curious person, though, and I like to read up on those things which affect me.

One thing I will say, is that I would never scoff at another person’s mental distress. I have slipped through cracks into misery and it is not a pleasant place to be. Bipolar II may be younger than me, but that doesn’t mean it doesn’t exist.

I realise I haven’t been blogging half as much of late, partly through being busy and partly through being singularly uninspired. Inspired by Blahpolar Diaries (a wonderful blog which you should all read: Blahpolar Diaries) I am challenging myself to write one post a day for 26 days. Each day I will pick something beginning with the corresponding letter of the alphabet and write about it. So today… A. I think I covered alcohol pretty well in my last post My Story, so what to write about? Let’s go with… Apples.

Apples are a mythical fruit. By which I do not mean that they have been invented and do not exist. Clearly, they do. Or, in certain philosophical circles, maybe they don’t, but in my world they certainly, certainly do. I really like them. I digress. What I mean is that apples feature in a couple of stories I have read, and they are interesting, at least to me.

From a poem I wrote years ago, entitled Greek Myths, as read at Age Nine:

Black sails with wrong-bad news

haunted my dreams for days.

So did pomegranate seeds- just two,

as bright as raindrops.

Another fruit, like the apple,

I made note to avoid

Why should apples be avoided?

Genesis: Eve

And when the woman saw that the tree was good for food, and that itwas pleasant to the eyes, and a tree to be desired to make one wise, she took of the fruit thereof, and did eat, and gave also unto her husband with her; and he did eat.
King James Bible

It is not altogether clear, in terms of translation, that it was in fact an apple that Eve ate. It could have been a different fruit. But let’s face it, the simple apple has been blamed for centuries for tempting Eve (along with Satan-as-serpent) and leading Adam astray. The basic outline of the story in Genesis, for those who do not know it, is this: Adam and Eve live happily in the Garden of Eden. They have free reign of the land and are allowed to roam (naked) and eat whatever they please- EXCEPT- for the fruit from the forbidden tree. One day, a serpent (possibly the devil incarnate) comes to Eve and tells her that the fruit of the forbidden tree is delicious and she should eat it. He tells her that the fruit of the tree will bring her knowledge such as she has never known before, and that this is why God does not want her to eat it. Tempted, Eve plucks an apple (let’s say apple) from the tree and takes a bite from it. She tells Adam that it is delicious and he, too, eats from it. Suddenly they become aware of their nakedness, cover themselves in fig leaves and hide. God asks how they knew they were naked, and they confess. Afterwards, he casts them from Eden. He makes the ground hard so that they must toil for the rest of their days. He makes childbirth painful. Children will be born with Original Sin. Angels and a sword then protect the Garden and Adam and Eve must work the ground from which they were made, in order to survive. Part of the apple remains lodged in Adam’s throat, which is why men have an Adam’s apple to this day.

I find this tale deeply problematic. I have a lot of questions about it. Let me know if I should publish them and I will add them to this post- I’m just conscious of making it too long.

Snow White: Poisoned Apple

The Brothers Grimm created the story of Snow White, the upshot of which is that, having had her life spared by a huntsman hired by her stepmother to cut out her heart, Snow White goes to live with seven dwarves. Learning (from a magic mirror) that the girl is still alive, the stepmother in question tries to kill her. In the final attempt, she disguises herself as an apple-seller and offers the girl a bite. Snow White takes a bite of what transpires to be a poisoned apple, and dies (later she is awoken by the kiss of a prince, whose mouth dislodges the fruit from her throat).

This story, too, is somewhat problematic, as Snow White in the original tale is around seven years of age. Her beauty should not be such a threat to her stepmother, and certainly not to the point where she would will the heart cut from the child. But such is the world of fairytale. I wrote my own version of Snow White. It wasn’t very good but made the stepmother more understandable and questioned why, in fact, a prince would be kissing a dead child.

There you go, my post for the day: apples. I promise to do better next time.

It is an absolutely beautiful day today, and I am happy. This is something I wrote on the Tube, feeling thoughtful.

***

Recovery

1) a return to a normal state of health, mind, or strength.2) the action or process of regaining possession or control of something stolen or lost.

Without

Days are lighter now. It’s the only way I can describe it. I’ve lost the weight that kept me anchored, all the things that stopped me dreaming. That may not sound like a bad thing, starting to dream, but as I sip my lime-and-soda, I wonder if the nightmares mightn’t come back…

Today

I don’t go to meetings any more. Each meeting is a promise I can’t keep, or a lie that I tell. The only requirement for membership is a desire to stop drinking. It’s a desire I no longer possess. For a while I had that drive, I held on to that hope, because drinking was wrecking my life. Moments after I “fell” from that window, I wondered, briefly, if I might not survive the impact. I felt the back of my head and, in my heightened state of drama, I felt blood on my fingers. There was no blood, no life-threatening damage ensued. The ankle snapped. I didn’t hear it. I was too busy listening to the rush of the breeze in my ears as I sailed- yes, I sailed- to the ground. (To anyone else’s eyes, it must have looked like a plummet). Through the haze of medication and alcohol, through the whispers and the shadows, I could feel only the darkness of unreality, closing me in yet leaving me lighter: falling, flying.

A week and a half later, after sliding up to my bedroom on my bum (crutches in one hand), I found the wine gone mouldy on my desk. I felt intense desire; I felt intense hatred. I felt, finally, that plummet, the plunge, that others had heard and seen but I not experienced.

I felt depth.

I hobbled in to my first meeting filled with doubt and despair and hope, and found hope there. In the dim candle-lit church hall, I found what they call identification. Recognition of oneself in another, their stories all partially mine. Heart at the base of my throat, I spoke, choked, imagining my tears lit up poetic by the tiny flames, yet hoping that that wasn’t the case.

Weeks later, in the same place, I met my future sponsor. And over the course if the months that followed, I found humour, and friendship, and a lightness I hadn’t experienced in years. Sometimes exhilarating, sometimes frightening. Sometimes quickly, sometimes slowly, I found my way.

And now?

Well, I moved back to London. I found similar support there and embraced it with what strength I could. Tried hard to stay afloat where I felt myself sinking, to stay dedicated where I felt myself falter… but slowly, quickly, I lost my drive. Circumstances got in the way; life got in the way. And I experienced what “they” would call relapse and I? Simply a change, not a darkness or a brightness but a subtle move from one form of living to another.

For months, I assumed I’d go back.

But as months passed, I began to re-learn myself. I lacked one type of strength- the strength that allows others to stay stopped. Yet I possessed another: that which allowed me to move through my life liberated from the vice-like (pun intended) grip that alcohol once held over my life. I don’t believe anyone can call themselves “recovered”. But I cope, and somehow, somewhere along the line, alcohol has lost its power to destroy, and I have developed the ability to enjoy.

It isn’t easy. Isn’t. Easy. There are moments and will always be, where I feel I have made a wrong move, that it will hold me in checkmate (chess not my strong point) until I surrender to the madness or return to meetings through those ever-open swinging doors. I would not be ashamed to turn back the way I came, if consequences became too dangerous, too dark. But for now I’m not unhappy, not unsafe.

So why this fear, when I think about stopping- just for a month? I’m in training for a half marathon. It’s something- if alcohol is no longer a problem for me- that I should be able to do. But I doubt, and I fear, and I waver. I dread the lightness I referred to at the start, leaving the hope of dreams and the terror of nightmares wide open. I fear for the strength that I lacked. I fear the revelation that I can’t, I can’t, I can’t- and what that would mean.

But what can I do but try? “Where can we live but days?” (Philip Larkin). A month is made up of weeks, are made up of days, are made up of hours and the challenge, such as it is, is a minute-by-minute thing. I learned that in meetings. I learned that as part of a new way to live.

But I don’t smoke. Didn’t. I mean, really. I say it to doctors and dentists and even my mum, but it’s true. Since the age of 14 I’d had about 5 fags in my life. ‘Til I came here. So it’s not that I’m desperate for this yellowy fag end. It’s just, I’ve decided that listening to five minutes on the efficiency of the pterodactyl as an alternative to The Flying Scotsman isn’t gonna do any harm. Actually, it’s a little bit intriguing. Racist Scottish Woman slips me the very end of the fag and goes inside. I open the door for her, balancing right-handed so as not to contravene smoking laws (IT IS ILLEGAL TO SMOKE ON A MENTAL HEALTH UNIT, the door-sign and the nurses’ faces say). Smoking is the only way you can get outside without hassle. Ironic, really, that a fresh air break is looked upon with suspicion but a casual lung-blackening gets you a nod and an open door.

Actually, a mental health unit is like a pub just after the ban. All the social happens outside. It’s an acquired taste, and it’s cold outside but there’s fuck all else to do. I started off getting other people to roll for me, shaky and inexpert at it. When I worked out how to do it myself it was a highlight, like popping the menthol bit on a new Pall Mall. Highlights, bear in mind, are not all that great in this place. Highlights include contraband aerosol deodorants, or being allowed to use your own phone charger.

Days. Yellow and and greenish detox pills; blue mood stabilisers; dazzly-pams, lozzie-pops. Nights, zoppies to make us treacly, hard pushed to try running through the thickness. In between just fags, fags, fags. I measure my steadiness by them, by the tightness of a roll, by learning to inhale without missing my mouth. Suck, hold, exhale. The courtyard is where Smurfy let me cry on his shirt and promised it’d get better and made me believe it a bit. It’s where Irish agreed to let me call him Irish, even though he isn’t. It’s the hair and the mouth, I keep telling him. And a compliment. It’s where Sunglasses routinely makes his jokes about using fingers (rollies), sucking deep, sucking boxes (wall-lighters for “safety”). He likes the word “suck” in almost any context. He swears the sunglasses are for some kind of light sensitivity, not a hipster statement. We don’t like his jokes, so pretend not to believe him.

The courtyard is also where Racist Scottish Woman called me a “Paki fucking doctor” all three of which were inaccurate. I threw a few things. Insults, a face-cloth when she came near me. A book, a mislaid punch and days later, a snowball at her back. Smurfy told me not to get wound but I know that snowball made his day.

DSM IV: Inappropriate Anger.

RSW informed me later that she loved “my people” and our “beautiful silk saris”. I told her to get one of her own and change her nasty sequinned skirt.

Highlights.

Fuck off, Old Dave shouts now, as Racist Scottish Woman goes inside. You old boot! I love Old Dave. He saves me the odd wink and returns me my socks. They keep going missing, weirdly, and I’m not totally sure I want them back. (Sunglasses).

I bought my own fags today. First time ever. I was allowed over the road to Tesco, escorted, and got some Menthols with the only money I thought to bring. I didn’t have any ID (my passport was slung across my desk at home, part of a brief unfulfilled escape plan). Kindly, the nurse pretended they were for her, and kindly the shop assistant pretended to believe her. Now, suddenly, I’m remembering, listening to Dave and Smurfy joke-fight, that I stuck them in the bloody washing machine. Trust that I bothered to wash stuff today, when I was about to prove I’m not a total bum. Lowlight. Still, I needed at least one of my three T-shirts to be clean. I got rushed here and nobody reminded me to bring a toothbrush. They don’t, do they, it isn’t them who’ll have to spend days without one, trying hard to care enough to ask for a spare. I started smoking and I started to care. Smoking= recovery? Anyway, I apologise about the fags spinning in the machine, probably a brownish gloop by now. And I think maybe nobody believes me, or maybe they do.

DSM IV: Paranoid Ideation.

Are the drugs making me a bit crazy?

Speaking of which, it is Pills O’clock. Nights are the worst, when I send my venom through the treacle, hateful texts aimed at the people I love(d?) most. My room mate snores, unblockable by iPod, Zopiclone, lorazepam, even the drink I’ll-Name-No-Names snuck in for me a couple of nights ago. At least the roommate has a way of getting them to let her out to smoke after lights out, and giving me a draw of the sleep-fag. A sleep-fag is different to a day-fag because it makes you woozy and chills you out, rather than keeping you semi-alert. Is that a highlight? Night’s a twilight here, I can’t be sure.

On the last night, I accept half a fag off Racist Scottish Woman. She’s let it burn ’til it’s as much ash as tobacco but I flick the cherry anyway and take a draw. We’ll share it, she says. It feels like an ending, a soap or a sitcom or Girl, Interrupted drawing to a disappointing climax. I watch Smurfy, Jess and Old Dave inside, laughing. Doesn’t smoke, Smurfy mouths. My arse.

Just a girl with an invisiable illness who is OBESSED with makeup. I'm a huge nerd who just wants to bring awearness to those who do not understand what it is like to be a spoonie. I also want to gush about all things beauty related.